TMSS Medical College Journal

Background: Nephrotoxicity is a common complication of Cisplatin based chemotherapeutics. Several factors are anticipated to be associated with this outcome. Objectives: This study aimed to determine the potential risk factors associated with Cisplatin-induced nephrotoxicity among Cancer patients in Bangladesh. Materials and Methods: A multicenter cross-sectional study was conducted in tertiary-level hospitals. A total of 87 Cancer patients receiving cisplatin-based chemotherapy were enrolled. Serum creatinine and estimated glomerular filtration rate (¢GFR) as indicative of nephrotoxicity were measured before and after cach chemotherapy cycle. Statistical analyses were performed to evaluate the risk factors associated with Cisplatin-induced nephrotoxicity. Results: Mean age of the patients was 47.0£12.6 years with 54% female and 46% male. Among 87 participants, nephrotoxicity was observed in 17.2% of patients. The Mann-Whitney U test showed a significant difference in age, baseline creatinine, and ¢GFR between normal and nephrotoxic groups (p=0.002, 0.001, 0.003 respectively). Binary logistic regression revealed increased odds of nephrotoxicity with increasing age (Odds Ratio (OR) =1.090, 95% CI: 1.026-1.157, p=0.005), diabetes (OR=8.500, 95% CI: 1.949-37.074, p=0.004), dose of cisplatin (OR=1.043, 95% CI: 1.003-1.085, p=0.037), and baseline eGFR (OR=0.953, 95% CI: 0.922-0.986, p=0.005). Diabetes increased the odds of nephrotoxicity by 8.5 times than non-diabetic. Conclusion: Increased age, being diabetic, high baseline creatinine and low baseline eGFR were key risk factors for nephrotoxicity. Adopting early preventive measures for risk groups may reduce the impact of Cisplatin-induced nephrotoxicity.

Cisplatin is a potent chemotherapeutic agent used for various solid neoplasia." > It is frequently used as an adjunct with other chemotherapeutic drugs.’ It exerts its cytotoxic anticancer properties by interfering with cellular replication through direct Deoxy-ribonucleic acid (DNA) damage which leads to defective gene expression and the production of Reactive oxygen species (ROS), and eventually cellular damage and death." **3 Despite its potency in Cancer treatment, it demonstrates multisystem cytotoxic effects like gastrointestinal toxicity, neurotoxicity, ototoxicity, marrow suppression, immunological reaction and notably nephrotoxicity with varying degrees of renal impairment which limits it use now-a-days. Among all these side effects of Cisplatin, nephrotoxicity is considered the most important and complicated because of the complexity of dose modification and ambiguous risk benefit ratio. Studies revealed that cisplatin can induce nephrotoxicity in 8-40% of cases.’